What are wet dressings?

These are a form of dressings where wet bandages are applied directly over moisturiser and steroid creams to help treat severe eczema or other skin conditions. This treatment can be modified so that wet clothing can be used instead of wet bandages. This change allows for easier and affordable wet dressings in a home setting.

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What are the benefits of wet dressings?

Hydrated skin allows better penetration of ingredients. Wet dressings ensure creams such as corticosteroids and moisturisers are able to penetrate the skin to a deeper level than if these creams were applied onto dry skin. They soothe the skin and reduce itch due to the cooling effect. They also protect the skin from the child’s scratching and prevent further skin damage.

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When to use wet dressings?

• Wet dressings are often used in the settling of severe or acute eczema flare up or other similar skin conditions.

• Wet dressings can be used 1- 3 times a day until the flare up settles.

• If used once daily, wet dressings are best used at night when children are most prone to scratching. These can be left overnight and removed in the morning.

• If used once daily, they are best done immediately after a bath.

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When not to use wet dressings?

• Avoid wet dressings if there is an active untreated skin infection, as a wet environment will likely worsen the skin infection.

• If your child is prone to folliculitis or pimples, check with your doctor prior to using wet dressings.

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What you need for modified wet dressings?

• Clean spoon or spatula to scoop out the moisturiser

• Thick, oily moisturiser

• Steroid creams as prescribed by your dermatologist (different strengths for different parts of the body)

• Luke-warm water in a bucket

• Multiple sets of cotton pyjamas or onesies. Use cotton ones, without itchy seams, zips or tags. Ideally, they should be close fitting. Often choose ones that are one size too small, so they sit right next to the skin.

• Flannel or face washer for applying to face

• Thick dressing gowns or loose-fitting dry pyjamas to wear over the top

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What are the steps for modified wet dressings?

It is important to prepare in advance so that all necessary equipment is at hand prior to starting the process. This makes the experience efficient and less traumatic for your child.

The steps to apply wet dressings are below:

• Wash your hands with soap and water.

• Scoop out some moisturiser from the tub with a clean spatula or spoon rather than hands to avoid contamination.

• Apply a thick layer of moisturiser to your child’s skin all over the body.

• Apply the appropriate steroid ointment as prescribed by your dermatologist to the eczema affected skin only (different steroid for face and body) – note that the steroid is able to dissolve and penetrate through the layer of moisturiser and hydrated skin is better able to absorb the steroid.

• Soak one set of your child’s pyjamas in a bucket of lukewarm water.

• Wring out the pyjamas so that they are damp (they should feel like clothing that has been through the spin cycle of the washing machine, damp but not dripping).

• Dress your child in the damp pyjamas.

• Place another layer of dry clothing over the wet pyjamas. These can be a set of larger cotton pyjamas or dressing gowns or even blankets.

• Keep the room warm but not hot.

• Allow your child to choose an activity that will keep them occupied and quiet for about an hour or so while they sit in their wet dressings (e.g. TV, board games, reading a book, etc).

• Remove the wet dressings after one hour and simply pat dry.

• Repeat as recommended by your dermatologist.

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What are the steps for modified wet dressings of face, hands, feet?

Face: As above but use a cotton flannel or face washer instead of the pyjamas.

Hands: As above but use white cotton gloves instead of the pyjamas.

Feet: As above but use white cotton socks that come at least up to the ankles instead of the pyjamas.

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This article was prepared by Dr Tevi Wain

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